# Dynamics of the prognostic index during the course of treatment for anaplastic thyroid carcinoma

## TL;DR

This study shows that the prognostic index (PI) can change during treatment for anaplastic thyroid carcinoma and may help guide treatment decisions.

## Contribution

The study demonstrates that PI can serve as a dynamic marker for assessing treatment response in anaplastic thyroid carcinoma.

## Key findings

- Patients with a low PI before and after treatment had the longest survival.
- A decrease in PI during treatment correlated with improved survival outcomes.
- An increase in PI during treatment was associated with worse survival.

## Abstract

Tumor/node/metastasis staging and prognostic index (PI) are used to predict prognosis and guide treatment for anaplastic thyroid carcinoma (ATC). With the advent of treatments, such as BRAF/MEK inhibitors and immune checkpoint inhibitors, dynamic markers to assess disease status and treatment efficacy are needed. This study examined the utility of PI as a dynamic marker for ATC treatment.

This retrospective study investigated 20 patients with ATC who were treated aggressively from January 2011 to December 2022. Patients were categorized into low-, high-, low-, and high-high groups according to the PI before and after treatment. Survival was then compared between the groups.

The median overall survival was not reached for the Low–Low, 363 days for the High–Low, 158.5 days for the Low–High, and 90.5 days for the High–High groups (p < 0.01). Among the 13 patients with an initially high PI, 6 patients achieved a low PI during treatment, but three showed subsequent increases. Categorizing PI further into decreased, temporarily decreased, and non-decreased groups, median overall survival was 363 days, 158.5 days, and 87 days, respectively (p < 0.01).

PI is a critical prognostic indicator that facilitates treatment decision-making for ATC. PI may also have potential as a dynamic marker for assessing the disease status and treatment efficacy.